Intimate partner violence (IPV) is the accepted term for physically, sexually or emotionally violent acts involving current or former spouses or partners. American women have a substantially higher rate of exposure to these acts than American men. In a study published in January 2015 in the journal Psychoneuroendocrinology, researchers from two U.S. institutions looked at the impact that exposure to physical intimate partner violence has on the chances that women will develop abnormal stress responses that could potentially harm their long-term well-being.

Physical Intimate Partner Violence

Acts of physical intimate partner violence are characterized by behaviors that intentionally or unintentionally result in non-sexual damage to the body of a spouse or partner. Examples of the behaviors that constitute this form of violence include slapping someone, punching someone, choking someone, scratching someone, burning someone with a heat source, tossing someone around, kicking someone, shoving someone, biting someone and grabbing someone. In addition, a spouse or partner commits an act of physical intimate partner violence if he or she uses the advantage of body weight or body size to hold someone down or otherwise impede movement. As a rule, the vast majority of these acts also meet the standard definitions of physical assault against anyone, not just a partner or spouse.

Several groups of women have unusually high odds of being exposed to IPV. Examples of these groups include women who have recently come to the U.S. from other countries, women over the age of 64 and women who partially or completely lack the ability to carry out independent daily routines. In addition, teenage girls have increased intimate partner violence risks. Data compiled by The American College of Obstetricians and Gynecologists indicates that the annual monetary cost of physical IPV and other forms of intimate partner violence is over $8 billion across the U.S.

Stress Reactions and Cortisol

When you’re exposed to notably stressful situations, your body naturally increases its output of a hormone called cortisol. If it circulates in large amounts in your bloodstream, this hormone helps turn on your “fight-or-flight” response and produces effects that include a spike in your blood sugar levels, suppression of hunger, altered reproductive function and activation of brain areas that control mood fluctuations and make you more susceptible to feeling tense or afraid. All people experience somewhat elevated cortisol levels when they wake up in the morning; however, unless a stressful event occurs, these levels quickly drop back down for the rest of the day. In people repeatedly exposed to stress, frequent cortisol elevations are associated with serious problems that include disruptions in higher-level mental function, sleep disturbances, depression and cardiovascular disease.

Physical IPV and Cortisol Levels

In the study published in Psychoneuroendocrinology, researchers from the Oregon Social Learning Center and the University of Oregon used data gathered from 122 young couples to examine the impact that intimate partner violence has on the daily cortisol cycles of men and women. All of the study participants were in their 30s; most had incomes that placed them on the lower end of the socioeconomic spectrum. For four days, the researchers took four daily cortisol samples from each participant. (Cortisol appears in saliva, so this process is relatively easy.) Times for taking these samples were morning wakeup, half an hour after waking up, the latter part of the afternoon and the latter part of the evening.

After comparing the results of the participants repeatedly exposed to intimate partner violence to the results of the participants with little or no IPV exposure, the researchers concluded that, among women, recurring exposure to physical IPV leads to considerable changes in normal daily cortisol levels. Specifically, compared to women unaffected or relatively unaffected by physical intimate partner violence, women who experience substantial physical IPV have an unusually slow rate of cortisol reduction in the latter part of the afternoon and also have unusually elevated nighttime cortisol levels. The researchers also concluded that men exposed to acts of physical intimate partner violence do not experience the same alterations in their daily cortisol levels. Since chronic exposure to heightened cortisol is associated with serious mental and physical health risks, women recurrently exposed to physical IPV may have substantially increased chances of developing stress-related mental and physical problems.

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